A battle for breath

Carte Blanche Medical aired a story about obstructive sleep apnoea (OSA) this week, a breathing disorder that occurs in 5% of women and 25% of men. Read more about this condition.

Carte Blanche Medical aired a story about obstructive sleep apnoea (OSA) this week, a breathing disorder that occurs in 5% of women and 25% of men. You can watch the video here.

Sleep apnoea is a breathing disorder that occurs during sleep and is typically accompanied by loud snoring. A person with sleep apnoea typically snores very loudly and then can suddenly – and briefly – stop breathing.

As a result, sufferers of sleep apnoea do not get enough oxygen during sleep and researchers are concerned that this condition could be linked to and even lead to, a number of other medical conditions. Read here about sleep apnoea being a heart risk, sleep apnoea and the increased risk of stroke and the possible genetic causes of OSA.

OSA is caused by something blocking the windpipe, the tongue, tonsils or uvula, although the most common cause is a collapse of the tongue backwards into the airway. Fatty tissue or lax throat muscles may also cause the blockage.

OSA can be deadly

Apart from the almost constant tiredness OSA sufferer’s have on a daily basis, studies have shown that it can be a deadly condition if left untreated.

A recent study in the journal Sleep showed that people with OSA have three times the risk of dying due to any cause compared with people who do not have sleep apnoea.

In the study, the participants regularly used continuous positive airway pressure (CPAP) therapy. This is the most common treatment for OSA as it provides a steady stream of air through a mask that is worn during sleep. The airflow is intended to keep the airway open which prevents the typical arrest in breathing and restores normal oxygen levels.

The study showed that statistical adjustments indicated that high blood pressure, cardiovascular disease, stroke and diabetes may play a role in the association between sleep apnoea and mortality, although the specific mechanisms by which sleep apnea contributes to mortality remain unclear.

One thing the researchers agreed on however, was that “people diagnosed with sleep apnoea should be treated, and if CPAP is the prescribed treatment, regular use may prevent premature death."

Brain damage in severe OSA

A separate study in the journal Sleep, showed that people with severe OSA have reduced concentrations of gray matter in multiple areas of the brain.

Gray matter refers to the brain's cerebral cortex, where the majority of information processing takes place. Changes in this brain structure may help explain the memory, cardiovascular and other problems experienced by people with OSA.

This finding puts even greater emphasis on early diagnosis and treatment of the condition.

"Poor sleep quality and progressive brain damage induced by OSA could be responsible for poor memory, emotional problems, decreased cognitive functioning and increased cardiovascular disturbances," said principal investigator Dr Seung Bong Hong, a professor of neurology at the Samsung Medical Centre, Sungkyunkwan University School of Medicine.

"The use of continuous positive airway pressure therapy could stop further progression of brain damage in patients with severe OSA."

Controlling OSA

Researchers across the world involved in sleep studies all agree that early detection and treatment is key for OSA sufferers and can make the difference between life and death.

One way in which it can be treated is through behavioural changes such as weight loss, not smoking and preferably not drinking before bedtime, the most effective treatments come in the form of mouth devices such as the CPAP, which is the most common form of treatment for CPAP.

Others include theBi-level Positive Air Pressure (BiPAP) machine which blows air at two different pressures; when the patient inhales, the pressure is higher and when exhaling, the pressure is lower. BiPAP is not for "more severe" cases - it is for people, for example with muscular dystrophy, who don’t have the strength to blow against the machine.

If treated correctly, whether it is through behavioural changes, C-PAP treatment or surgery, a sufferer of sleep apnoea could be successfully cured of this debilitating condition and once again enjoy a quality life thanks to quality sleep.

Ask the Expert

Dr Alison Bentley is a general practitioner who has consulted in sleep medicine and sleep disorders, in both adults and children of all ages, for almost 30 years. She also researches and publishes on a number of sleep-related topics both in formal research journals and lay publications including as editor of Sleep Matters, an educational newsletter on sleep disorders for doctors.

posted on 02/05/2017

posted on 28/04/2017

posted on 26/04/2017

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